Thyroid carcinoma (TC) is one of the fastest-growing cancers in the world. Finding new biomarkers with high specificity, high sensitivity and non-invasive characteristic for early diagnosis and postoperative detection has become a research focus. Exosome, an important carrier of intercellular communication with high stability, low cytotoxicity, low immunogenicity, and high membrane permeability, has the potential to become a non-invasive and new means of disease diagnosis and treatment. In recent years, there have been substantial breakthroughs for exosomes in non-invasive diagnosis, detection, administration, treatment, and prognostic evaluation of thyroid cancer. This article reviews the research progress of TC-derived exosomes in tumor development and progression, diagnosis, and therapy.